DIABETES MELLITUS, NON-INSULIN-DEPENDENT

General Information

DEFINITION--A disease of metabolism characterized by the body's inability to produce enough insulin to process carbohydrates, fat and protein efficiently. Non-insulin-dependent diabetes mellitus is most prevalent among obese adults.

BODY PARTS INVOLVED

• Islet cells of the pancreas that produce insulin.
• All body cells that need insulin to convert food into chemicals the body can use.

SEX OR AGE MOST AFFECTED--Both sexes of adults.

SIGNS & SYMPTOMS

• Fatigue.
• Excess thirst.
• Increased appetite.
• Frequent urination.
• Decreased resistance to infection, especially urinary-tract infections and yeast infections of the skin, mouth or vagina.

CAUSES

• Insufficient insulin produced by the pancreas to sustain normal function of body cells.
• Interference with insulin utilization in body cells for unknown reasons.

RISK INCREASES WITH

• Obesity in adults.
• Stress.
• Pregnancy.
• Use of certain drugs, including oral contraceptives, thiazide diuretics, cortisone or phenytoin.
• Family history of diabetes mellitus.

HOW TO PREVENT

• Control your weight to avoid becoming obese.
• Maintaining a regular exercise program may help prevent or delay NIDDM.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Laboratory urine and blood studies to meas-ure glucose, cholesterol and insulin levels.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Surgery for treatment of some complications, such as gangrene or heart disease.

POSSIBLE COMPLICATIONS

• Cardiovascular disease, especially atherosclerosis, stroke and coronary-artery disease.
• Vision impairment.
• Peripheral vascular disease, with gangrene in legs and feet and sexual impotence in men (sometimes).
• Hypoglycemia, if oral hypoglycemic medication is used (rare).

PROBABLE OUTCOME--This form of diabetes can often be controlled with weight loss. Good control decreases the chance of complications. In some cases, it progresses to insulin-dependent diabetes, a more serious form.

How To Treat

GENERAL MEASURES--

• Learn to test your urine for glucose (sugar).
• Learn all you can about controlling diabetes and recognizing signs and symptoms of complications.
• Wear a Medic-Alert pendant or bracelet (See Glossary).
• Lose weight to a normal level and maintain your ideal weight.
• Obtain prompt medical treatment for any infection or injury.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe oral medicines to reduce blood sugar (hypoglycemics). These are not always necessary. They can often be discontinued when body weight becomes normal.

ACTIVITY--No restrictions. Regular daily exercise is an important part of controlling diabetes. Consult your doctor.

DIET--A special diet will be necessary to: reduce weight; limit refined carbohydrates; balance unrefined carbohydrates, protein and fat; and increase plant fiber. Your doctor will provide instructions.

Call Your Doctor If

• You have symptoms of diabetes mellitus.
• The following occurs during treatment: Inability to think clearly; weakness; sweating; paleness; rapid heartbeat; seizures; coma (may indicate hypoglycemia). Numbness, tingling or pain in the feet or hands. Infection that does not improve in 3 days. Chest pain. Worsening of original symptoms, despite adherence to treatment.